Risky sexual behaviours, coping responses and parent-adolescent communication in South-Central Uganda

Abstract

Adolescents in Uganda face multiple vulnerabilities and exposures to risks. Approximately 25% of Ugandan teenagers become pregnant by the age of 19 years. This study explored and examined risky sexual behaviours, coping responses and parent communication among adolescents in South-Central Uganda. This was a mixed-methods study design. Quantitative study utilised secondary data from round 19 of the Rakai Community Cohort Study (RCCS), a longitudinal population-based HIV surveillance cohort. The qualitative study involved focus group discussions, in-depth interviews with adolescents and key informant interviews with parents/caregivers. Chi-square, logistic regression and negative binomial regression models were fitted to determine the risky sexual behaviours among adolescents. Qualitative data analysis adopted an interpretivist thematic content analysis approach to understand adolescent coping responses and adolescent communication. Adolescents aged 18-19 exhibited a significantly higher incidence of risky sexual behaviours compared to those aged 15-17 (aIRR = 2.01, 95% CI: 1.77-2.28). 17 years (aIRR = 2.01, 95% CI: 1.77-2.28). On the other hand, school attendance and being a student were protective factors (aIRR = 0.38, 95% CI: 0.32-0.44), reducing the likelihood of risky sexual engagement. Also, the likelihood of RSB reduces with higher education. Living in a single-mother family structure (aIRR = 1.36, 95% CI: 1.15-1.60), with other relatives (aIRR = 1.34, 95% CI: 1.12-1.60), with non-relatives (aIRR = 1.53, 95% CI: 1.21-1.94), or alone (adolescent-headed) (aIRR = 1.68, 95% CI: 1.34-2.10) were all associated with higher incidence rates compared to living with both biological parents. Parents acknowledged that talking with adolescents could help reduce risky sexual behaviour. Parental talks on sexual matters were usually unplanned and happened when triggered by specific incidents. Evidence from the results suggests that adolescents engage in risky sexual behaviours, including non-marital sexual partnerships, multiple sexual partners, unprotected sex with a non-marital partner, and transactional sex. Parent-adolescent communication on sexual matters is essential/pertinent approach is needed to reduce/avert the associated risks. There is a need for continuous engagement of all different stakeholders involved in adolescent work to have targeted interventions to prevent risky sexual behaviours among young people.